人免疫球蛋白治疗新生儿肺炎患儿的疗效及对血清IL-6、PCT水平的影响

The therapeutic effect of human immunoglobulin on neonates with pneumonia and its effect on serum IL-6 and PCT levels

目的探讨人免疫球蛋白治疗新生儿肺炎患儿的疗效及对血清白介素-6(IL-6)、降钙素原(PCT)水平的影响。方法收集2019年3月—2020年4月苏州市立医院本部新生儿科住院治疗并确诊为新生儿肺炎的患儿152例,采用随机数字表法分为对照组(n=76)和研究组(n=76)。2组新生儿肺炎患儿按照病情给予抗感染、化痰、给氧等治疗;研究组在常规治疗基础上静脉注射人免疫球蛋白,7 d后评价疗效,检测治疗前后血清PCT、IL-6、hs-CRP水平和外周血WBC及中性粒细胞比值(NEUT),观察临床症状和体征消失时间,以及患儿用药的不良反应情况。结果研究组的总有效率为94.74%,明显高于对照组的77.63%,差异具有统计学意义(χ^2=9.338,P<0.01);治疗后,2组患儿血清PCT、IL-6、hs-CRP、WBC和NEUT较治疗前显著降低(P均<0.05),研究组患儿血清PCT、IL-6、hs-CRP、WBC和NEUT较对照组明显下降(t/P=6.794/0.006、9.794/0.001、5.863/0.004、5.794/0.009、4.875/0.036);治疗后,2组患儿IgG、IgM和IgA水平明显高于治疗前(P均<0.05),研究组治疗后IgG、IgM和IgA水平明显高于对照组(t/P=6.872/0.007、5.921/0.009、6.645/0.011);研究组患儿治疗后,呼吸困难、肺部啰音、发热、咳嗽症状和住院天数较对照组明显缩短(P均<0.01),2组在治疗期间均未出现不良反应。结论人免疫球蛋白治疗新生儿肺炎患儿的疗效显著,未发现不良反应,明显降低了血清IL-6和PCT水平,提高机体的免疫能力,减轻患儿的临床症状。

Objective To explore the effect of human immunoglobulin on neonatal pneumonia in children and its effect on serum IL-6 and PCT levels.Methods 152 children admitted to our hospital for pediatric hospitalization and diagnosed with neonatal pneumonia from March 2019 to April 2020 were collected and divided into groups using a random number method,divided into a control group(n=76)and a research group(n=76).The two groups of neonates with pneumonia were treated with anti-infective drugs according to their condition,and the treatment of adding phlegm was required to provide oxygen for patients with dyspnea;the research group injected intravenous human immunoglobulin on the basis of the treatment in the control group.Before and after treatment,the bed efficacy of neonates with pneumonia was compared,the serum PCT,IL-6,hs-CRP levels and peripheral blood hemogram were detected,and the clinical symptoms and signs were compared with the side effects of the drugs used by the children.Results The total effective rate in the study group was 94.74%,which was significantly higher than the total effective rate in the control group,77.63%,the difference was statistically significant(χ^2=9.338,P<0.01);PCT in the serum of the control group and the study group after treatment,IL-6,hs-CRP,white blood cell and neutrophil ratio were significantly lower than before treatment(P<0.05),after treatment,the serum PCT,IL-6,hs-CRP,white blood cell and neutrophil ratio in the study group were lower than those of control group(t/P=6.794/0.006,9.794/0.001,5.863/0.004,5.794/0.009,4.875/0.036).The levels of IgG,IgM and IgA were significantly higher than those before treatment after treatment(P<0.05),and the levels of IgG,IgM and IgA were significantly higher in the study group after treatment than those of control group(t/P=6.872/0.007,5.921/0.009,6.645/0.011);after treatment of neonatal pneumonia in the study group,the symptoms of dyspnea,lung rales,fever,cough symptoms and hospitalization days were significantly reduced compared with the control group(all P<0.01),both groups of neonates with pneumonia had adverse reactions during the treatment period.Conclusion Human immunoglobulin is effective in the treatment of neonates with pneumonia.No adverse reactions were found.The serum IL-6 and PCT levels were significantly reduced,the body's immunity was improved,and the clinical symptoms of the children were alleviated.